大象传媒

鈥淗i-my-name-is-Nisha-I-am-a-medical-student-I-am-going-to-ask-you-some-questions-before-Dr.-James-comes-in,鈥� I said in one breath, so fast that the words almost slurred together. I had gotten into the habit of saying this phrase quickly, before that concerned, confused look that often appeared when I walked into an exam room could spread across the patient鈥檚 face. Yes, I know I鈥檓 just a student, I tried to convey in that rushed, almost apologetic introduction. I know I don鈥檛 have that much to offer you. The two women in the room looked at me and, just as I expected, the younger woman seemed to relax a little when she heard the words before Dr. James comes in, satisfied that she would soon be seeing a real doctor.

As I walked over to take a seat, I glanced at the two women in the room. The younger woman looked about forty. Her face appeared tired, stressed, and maybe even a little frustrated. The older woman slumped in her seat, her glasses threatening to fall off her face. She looked scared.

鈥淲hat brings you in today?鈥� I asked.

鈥淲ell鈥︹�� the younger woman replied, glancing over at the older woman. She began to tell me about the phone call she received from her mother鈥檚 nurse at the assisted living facility. The nurse, she said, had become worried after seeing large amounts of blood in her mother鈥檚 stool earlier that day. As I began to construct a differential diagnosis in my mind, I turned to the older woman.

鈥淐ould you tell me if you experienced any pain when鈥斺��

鈥淲HO ARE YOU?鈥�

Startled, I glanced at the younger woman and then back at her mother. 鈥淚 am a medical student here for the week. I am going to ask you a few questions before Dr. James comes in.鈥� She looked terrified. I wasn鈥檛 sure as I stared at her whether I had ever seen someone look that scared before, at least outside of a movie. I hesitated, unsure of whether or not to go on.

鈥淪he has dementia,鈥� her daughter told me. 鈥淪he has good days and really bad days. Today hasn鈥檛 been the best. She doesn鈥檛 remember it is my birthday.鈥�

鈥淲HO IS SHE?鈥� the woman demanded again, this time looking at her daughter.

鈥淎 medical student. It鈥檚 okay. She鈥檚 just asking some questions.鈥�

There was a pause after she said this as the three of us looked at each other. The younger woman still looked tired, the older woman still looked scared, and I am sure that I looked uncertain as I attempted to register the statement She doesn鈥檛 remember it is my birthday. Maybe it was the matter-of-fact tone she used when she said it, or that birthdays have always been a grand affair in my family, but the words left me feeling sad and empty. As I gathered my thoughts and prepared to continue with my questioning, Dr. James swung open the door and walked into the room. I scurried out of the 鈥渄octor chair鈥� and over to the wall, making room for him to sit down. It was clear to me as Dr. James began to question the younger woman that he had been taking care of these patients for years.

鈥淕iven her age,鈥� he said after gathering the story, 鈥淚 don鈥檛 think I would recommend a colonosc鈥斺��

鈥淗elp me. It hurts so bad.鈥� Although the older woman鈥檚 previous exclamation had startled me, this quiet, desperate, frightened plea caught me completely off guard. The words were drawn out, her voice shaky. It was a painful sound to listen to, like long pointy nails scratching on a chalkboard. It was the kind of sound that gives you goosebumps, sends shivers down your spine, drives you to instinctively reach up and cover your ears. The kind of sound that makes you desperately want to do something to help, and makes you pray that you will never in your life be in that much pain. She looked directly at Dr. James and pleaded again 鈥淧lease help me. Please.鈥�

鈥淚鈥檓 trying to help you,鈥� Dr. James replied calmly, patting her knee with a comforting smile and then continuing to explain the options to her daughter.

The older woman then turned to her daughter and muttered another frantic plea. 鈥淧lease help me. It hurts.鈥� The younger woman absent-mindedly patted her mother鈥檚 knee while continuing her conversation with Dr. James, giving me the impression that she had heard these pleas so often from her mother that they had turned into background noise.

Finally, the older woman turned to look at me, wide-eyed, helpless, and afraid. 鈥淧lease, help me. Please.鈥� I started to feel panicky. I had no idea what to do. I wanted to cry. I looked at Dr. James and the younger woman as they continued to converse, then turned back to meet the older woman鈥檚 desperate gaze again. I felt like I was going to explode under that wide-eyed, unwavering gaze, and finally I burst out 鈥淲hat鈥檚 hurting her? What鈥檚 happening to her?鈥�

鈥淲e鈥檙e not sure. She won鈥檛 tell us when we ask. She鈥檚 been doing this for a while now,鈥� her daughter replied to me in that same matter-of-fact tone. She doesn鈥檛 remember it is my birthday. She鈥檚 being doing this for a while now. I imagined as I stood there, drifting in and out of the conversation between her and Dr. James, how much grief she must have been through. How many times had she been forced to stand there helpless while her terrified mother begged her to make this horrible pain stop? What had it taken her to get to a point where she could talk about it all with such detachment?

 

I won鈥檛. I won鈥檛 ever go through that, or put others through that, I thought, feeling rather desperate myself. If I鈥檓 ever diagnosed with dementia, I鈥檒l find some way out.

Dr. James stood up to leave, bringing my wandering mind back to the exam room. As I turned to follow him, I heard a voice behind me: 鈥淚 love her.鈥� Dr. James and I both turned around. 鈥淵ou love your daughter? She is pretty great. Today is her birthday you know,鈥� Dr. James said with a smile to the older woman.

鈥淣o,鈥� she said. 鈥淚 love her.鈥�

There was a pause as all of us realized that she was pointing to me.

鈥淚 love her.鈥� Her tone was different now. She sounded less desperate. Her voice was stronger, like she was finally sure of something. She rested her pointing finger back in her lap, but kept her eyes fixed on me.

鈥淲eird,鈥� her daughter said with an uncomfortable laugh. 鈥淚 haven鈥檛 seen her do this before.鈥� As she helped her mother up and pushed her towards the door, the older woman grabbed my arm. Her icy fingers closed so tightly around me that I was worried she would never let go. What is going on? I thought. What do I do? This is horrible. It鈥檚 all so horrible. I don鈥檛 know what to do. None of this makes any sense. Dr. James, maybe hoping to avoid a scene, gently suggested that I walk the women to their car in the parking lot.

鈥淩eally, she never does this,鈥� her daughter told me apologetically as we approached the car, probably sensing my discomfort. 鈥淚t鈥檚 okay,鈥� I replied, feeling like I myself was in a daze. I鈥檓 not sure exactly how we got her into the car or how I got my arm out of her icy grip. All I remember is her continuing to say those strange words, I love you, as I shut the door behind her.